基于MRI的前列腺癌放疗中标志物手动辨识与定位评价

Manual identification and localization evaluation of marker in prostate cancer radiotherapy based on magnetic resonance imaging

    摘要
  • 摘要:
    目的 评价基于MRI的前列腺癌放疗中黄金基准标志物（GFM）手动辨识和定位方法的效能。
    方法 纳入2019年6月至2021年6月于唐山市人民医院接受治疗的16例前列腺癌患者进行前瞻性研究，年龄（58.5±4.1）岁，每例患者均置入了3枚GFM后接受放疗定位CT扫描，然后采用单独序列（SS）法和组合序列（CS）法对所有患者进行MRI检查。由5名放疗医师分别对2种序列法获得的所有图像进行GFM手动辨识和定位。计算单个GFM中心（CsGFM）坐标均值和3枚GFM空间质心（CmGFM）坐标均值，并采用Bland-Altman分析法分别评价2种序列法定位的一致性。通过与CT定位比较并计算GFM的标志物间距（IMD），评价2种序列法定位的准确度，组间比较采用配对样本t检验。
    结果 SS法GFM辨识阳性率为79.17%（38/48），CS法为93.75%（45/48）。（1）一致性结果。SS法中，每名放疗医师计算的GFM中心坐标同所有GFM的CsGFM坐标均值在左右、头脚、腹背3个方向上的95%一致性界限（LoA）范围分别为−1.46~0.97 mm、−1.06~1.73 mm、−1.96~1.12 mm；CS法中分别为−0.79~1.09 mm、0.10~1.47 mm、−0.87~1.40 mm。SS法中，每名放疗医师计算的3枚GFM空间质心坐标同所有患者的CmGFM坐标均值在左右、头脚、腹背3个方向上的95%LoA范围分别为−1.38~0.94 mm、−1.60~1.07 mm、−1.07~1.75 mm；CS法中分别为−0.57~0.76 mm、−0.71~0.98 mm、−1.16~0.76 mm。（2）准确度结果。与CT定位比较，SS法中IMD为（0.59±0.39） mm，显著大于CS法中的（0.32±0.17） mm，且差异有统计学意义（t=−1.89，P=0.027）。
    结论 基于MRI的2种GFM手动辨识和定位方法的效能均可满足临床要求，其中CS法GFM手动辨识的阳性率、定位一致性和准确度均优于SS法。

     

    Abstract:
    Objective To evaluate the effectiveness of manual identification and localization methods of gold fiducial marker (GFM) in prostate cancer radiotherapy based on MRI.
    Methods Sixteen patients with prostate cancer who were treated in Tangshan People's Hospital from June 2019 to June 2021 were included in this prospective study. The age of patients was (58.5±4.1) years. All the patients received radiotherapy localization CT scan after the implantation of three GFMs. Single-sequence (SS) and combined sequence (CS) method were used for MRI scanning for all the patients. All GFMs on the images obtained by the two sequencing methods were manually identified and located by five radiologists. The average coordinates of a single GFM center (CsGFM) and three GFM space centroids (CmGFM) were calculated. The consistency of the two sequencing methods was evaluated using Bland-Altman method. Sequencing accuracy was determined by comparison with CT localization and calculation of the imter-marker distance (IMD) of GFM. The difference between groups was analyzed by paired sample t test.
    Results The positive rate of GFM identification by SS method was 79.17% (38/48), and that of CS method was 93.75% (45/48). (1) In SS method, the range of 95% limit of agrecment (LoA) between the GFM central coordinate calculated by each radiologist and the mean value of CsGFM coordinates in left-right, superior-inferior, and anterior-posterior directions were −1.46–0.97, −1.06–1.73, and −1.96–1.12 mm, respectively; in CS method, the values were −0.79–1.09, 0.10–1.47, and −0.87–1.40 mm, respectively. In SS method, the 95%LoA of the three GFM space centroid coordinates calculated by each radiologist and the mean value of CmGFM coordinates in left-right, superior-inferior, and anterior-posterior directions were −1.38–0.94, −1.60–1.07, and −1.07–1.75 mm, respectively; in CS method, the values were −0.57–0.76, −0.71–0.98, and −1.16–0.76 mm, respectively. (2) For accuracy, compared with CT localization, the IMD in SS method was (0.59±0.39) mm, which was significantly higher than that in CS method (0.32±0.17) mm. The difference was statistically significant (t=−1.89, P=0.027).
    Conclusion The effectiveness of two manual identification and localization methods of GFM based on MRI can meet the clinical requirement. The positive rate, localization consistency and accuracy of CS method are superior to those of SS method.

     

    • HTML全文
    • 参考文献(18)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回